AIM:To investigate the effectiveness of a modified inferior oblique muscle belly transposition for treatment of V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction.METHODS:Thirteen ca...AIM:To investigate the effectiveness of a modified inferior oblique muscle belly transposition for treatment of V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction.METHODS:Thirteen cases(23 affected eyes)of V-pattern exotropia with inferior oblique muscle overaction(+or++)who underwent the modified inferior oblique muscle belly transposition procedure were retrospectively reviewed.The amount of V-pattern,grade of inferior oblique overaction,degree of vertical strabismus,abnormal head posture,and the fovea-disc angle were evaluated before and after surgery.RESULTS:The V-pattern was corrected in all cases,and the amount of V-pattern reduced by 17.85±5.13 prism diopter(PD)on average(t=16.07,P<0.001).The surgical cure rate for mild to moderate inferior oblique muscle overaction was 87.0%(20/23).The degree of the foveadisc angle has a mean reduction of 5.45°±2.87°(t=3.95,P=0.003)after surgery.The mean vertical deviation in 5 cases with a small-angle hypertropia(5.23±3.06 PD)in the primary position reduced by 3.15±1.86 PD(t=6.10,P<0.001).No serious complications were observed.CONCLUSION:The modified inferior oblique muscle belly transposition procedure can effectively treat mild to moderate inferior oblique overaction and relieve the V-pattern,which is safe and easy to perform.展开更多
AIM: To investigate the therapeutic effects of simultaneous horizontal and vertical operations on dissociated vertical deviation(DVD) associated with other deviations.METHODS: Forty-five cases of DVD with horizontal a...AIM: To investigate the therapeutic effects of simultaneous horizontal and vertical operations on dissociated vertical deviation(DVD) associated with other deviations.METHODS: Forty-five cases of DVD with horizontal and torsional strabismus underwent combined operation were collected retrospectively. All clinical records were analyzed. All patients were followed up for 6 to 24 mo. Wilcoxon signed-ranks test was performed to evaluate the changes of vertical and horizontal deviation. χ~2 test was used to evaluate the changes of binocular visual function. RESULTS: Forty-five cases included 36 patients with intermittent exotropia and binocular inferior oblique overaction(IOOA), 5 patients with concomitant esotropia and binocular IOOA, 4 patients with intermittent exotropia and monocular superior oblique palsy. The superior rectus recession(SRR) combined with horizontal rectus recession and the myectomy of inferior oblique or anterior transposition were operated simultaneously to correct all types of strabismus. There were 43 cases who achieved normal eye position in vertical direction, while 2 cases were with undercorrection of 5~Δ to 6~Δ. In patients with horizontal strabismus, 2 cases of exotropia were with overcorrection of 6~Δ to 8~Δ, 1 case of esotropia was with undercorrection of 6~Δ, and 1 case of monocular superior oblique palsy with compensatory head posture was not significantly improved. The binocular visual function of most patients recovered after operation. The difference of the binocular visual function and eye position were significant compared with that before operation(P<0.05).CONCLUSION: The simultaneous operation on DVD with horizontal and torsional strabismus is successful.展开更多
AIM:To compare outcomes of conventional and Hangback methods of inferior oblique(IO)recession in V-pattern strabismus with inferior oblique overaction(IOOA).METHODS:Comparative randomized study was conducted consistin...AIM:To compare outcomes of conventional and Hangback methods of inferior oblique(IO)recession in V-pattern strabismus with inferior oblique overaction(IOOA).METHODS:Comparative randomized study was conducted consisting of 50 patients,age 6 to 35 y having V-pattern strabismus[>15 prism diopter(PD)]with IOOA.They were divided equally in two groups and underwent IO recession,group A by conventional method and group B by Hang-back method.Parameters evaluated were reduction in V-pattern and IOOA,shift in torsion,improvement in binocular status.Success was a residual V-pattern of less than 10 PD at 1 y of follow up.RESULTS:The mean V-pattern preoperatively and postoperatively at 1 y was 24±5.4 PD and 4.2±3.51 PD in group A and 23.44±6.44 PD and 5.76±3.8 PD in group B respectively.The mean reduction in V-pattern was 20±6.78 PD in group A and 18.2±5.48 PD in group B.The mean correction of IOOA was 18.48±3.13 PD in group A and 16±2.93 PD in group B.Mean shift in extorsion was 3.08±1.8 degree in group A and 3.72±2.14 degree in group B.CONCLUSION:Both the procedures achieve a significant and comparable reduction in V-pattern and IOOA.Hang-back recession being a landmark free surgery eliminates the need for intrascleral suturing thereby reducing the risk of scleral perforation with possible postoperative adjustment of muscle.It may be considered as a good alternative for IO recession in patients of V-pattern strabismus with mild to moderate amount of IOOA.展开更多
AIM:To compare the changes in excyclotorsion after inferior oblique(IO)recession in patients with primary and secondary inferior oblique overaction(IOOA).METHODS:We retrospectively analyzed the data obtained from pati...AIM:To compare the changes in excyclotorsion after inferior oblique(IO)recession in patients with primary and secondary inferior oblique overaction(IOOA).METHODS:We retrospectively analyzed the data obtained from patients with IOOA who underwent graded IO recession.The patients were followed up for at least 3 mo after surgery.Fundus photographs were taken preand postoperatively,and the sum of the angles of torsion in both eyes was used to analyze changes in excyclotorsion.Patients were divided into two groups:those diagnosed with primary IOOA were enrolled in the 1’IOOA group,and those diagnosed with secondary IOOA caused by superior oblique palsy(SOP)were enrolled in the 2’IOOA group.Excyclotorsion before and after surgery were compared between the two groups.RESULTS:A total of 78 patients were enrolled in this study:34 eyes in the 1’IOOA group and 44 eyes in the 2’IOOA group.In the 78 patients,torsional angle significantly decreased from 15.31°±7.40°to 12.11°±6.53°after IO recession(P<0.001).Mean preoperative torsional angle was larger in the 2’IOOA group than in the 1’IOOA group(P=0.03).In both groups,excyclotorsion significantly decreased after IO recession(P=0.001 and P<0.001,respectively);however,there was no significant difference in the amounts of changes in excyclotorsion between the two groups.CONCLUSION:Excyclotorsion is significantly larger in secondary IOOA than in primary IOOA,and a significant decrease in the torsional angle occurs after IO recession in both types of IOOA.展开更多
文摘AIM:To investigate the effectiveness of a modified inferior oblique muscle belly transposition for treatment of V-pattern exotropia combined with mild to moderate inferior oblique muscle overaction.METHODS:Thirteen cases(23 affected eyes)of V-pattern exotropia with inferior oblique muscle overaction(+or++)who underwent the modified inferior oblique muscle belly transposition procedure were retrospectively reviewed.The amount of V-pattern,grade of inferior oblique overaction,degree of vertical strabismus,abnormal head posture,and the fovea-disc angle were evaluated before and after surgery.RESULTS:The V-pattern was corrected in all cases,and the amount of V-pattern reduced by 17.85±5.13 prism diopter(PD)on average(t=16.07,P<0.001).The surgical cure rate for mild to moderate inferior oblique muscle overaction was 87.0%(20/23).The degree of the foveadisc angle has a mean reduction of 5.45°±2.87°(t=3.95,P=0.003)after surgery.The mean vertical deviation in 5 cases with a small-angle hypertropia(5.23±3.06 PD)in the primary position reduced by 3.15±1.86 PD(t=6.10,P<0.001).No serious complications were observed.CONCLUSION:The modified inferior oblique muscle belly transposition procedure can effectively treat mild to moderate inferior oblique overaction and relieve the V-pattern,which is safe and easy to perform.
文摘AIM: To investigate the therapeutic effects of simultaneous horizontal and vertical operations on dissociated vertical deviation(DVD) associated with other deviations.METHODS: Forty-five cases of DVD with horizontal and torsional strabismus underwent combined operation were collected retrospectively. All clinical records were analyzed. All patients were followed up for 6 to 24 mo. Wilcoxon signed-ranks test was performed to evaluate the changes of vertical and horizontal deviation. χ~2 test was used to evaluate the changes of binocular visual function. RESULTS: Forty-five cases included 36 patients with intermittent exotropia and binocular inferior oblique overaction(IOOA), 5 patients with concomitant esotropia and binocular IOOA, 4 patients with intermittent exotropia and monocular superior oblique palsy. The superior rectus recession(SRR) combined with horizontal rectus recession and the myectomy of inferior oblique or anterior transposition were operated simultaneously to correct all types of strabismus. There were 43 cases who achieved normal eye position in vertical direction, while 2 cases were with undercorrection of 5~Δ to 6~Δ. In patients with horizontal strabismus, 2 cases of exotropia were with overcorrection of 6~Δ to 8~Δ, 1 case of esotropia was with undercorrection of 6~Δ, and 1 case of monocular superior oblique palsy with compensatory head posture was not significantly improved. The binocular visual function of most patients recovered after operation. The difference of the binocular visual function and eye position were significant compared with that before operation(P<0.05).CONCLUSION: The simultaneous operation on DVD with horizontal and torsional strabismus is successful.
文摘AIM:To compare outcomes of conventional and Hangback methods of inferior oblique(IO)recession in V-pattern strabismus with inferior oblique overaction(IOOA).METHODS:Comparative randomized study was conducted consisting of 50 patients,age 6 to 35 y having V-pattern strabismus[>15 prism diopter(PD)]with IOOA.They were divided equally in two groups and underwent IO recession,group A by conventional method and group B by Hang-back method.Parameters evaluated were reduction in V-pattern and IOOA,shift in torsion,improvement in binocular status.Success was a residual V-pattern of less than 10 PD at 1 y of follow up.RESULTS:The mean V-pattern preoperatively and postoperatively at 1 y was 24±5.4 PD and 4.2±3.51 PD in group A and 23.44±6.44 PD and 5.76±3.8 PD in group B respectively.The mean reduction in V-pattern was 20±6.78 PD in group A and 18.2±5.48 PD in group B.The mean correction of IOOA was 18.48±3.13 PD in group A and 16±2.93 PD in group B.Mean shift in extorsion was 3.08±1.8 degree in group A and 3.72±2.14 degree in group B.CONCLUSION:Both the procedures achieve a significant and comparable reduction in V-pattern and IOOA.Hang-back recession being a landmark free surgery eliminates the need for intrascleral suturing thereby reducing the risk of scleral perforation with possible postoperative adjustment of muscle.It may be considered as a good alternative for IO recession in patients of V-pattern strabismus with mild to moderate amount of IOOA.
文摘AIM:To compare the changes in excyclotorsion after inferior oblique(IO)recession in patients with primary and secondary inferior oblique overaction(IOOA).METHODS:We retrospectively analyzed the data obtained from patients with IOOA who underwent graded IO recession.The patients were followed up for at least 3 mo after surgery.Fundus photographs were taken preand postoperatively,and the sum of the angles of torsion in both eyes was used to analyze changes in excyclotorsion.Patients were divided into two groups:those diagnosed with primary IOOA were enrolled in the 1’IOOA group,and those diagnosed with secondary IOOA caused by superior oblique palsy(SOP)were enrolled in the 2’IOOA group.Excyclotorsion before and after surgery were compared between the two groups.RESULTS:A total of 78 patients were enrolled in this study:34 eyes in the 1’IOOA group and 44 eyes in the 2’IOOA group.In the 78 patients,torsional angle significantly decreased from 15.31°±7.40°to 12.11°±6.53°after IO recession(P<0.001).Mean preoperative torsional angle was larger in the 2’IOOA group than in the 1’IOOA group(P=0.03).In both groups,excyclotorsion significantly decreased after IO recession(P=0.001 and P<0.001,respectively);however,there was no significant difference in the amounts of changes in excyclotorsion between the two groups.CONCLUSION:Excyclotorsion is significantly larger in secondary IOOA than in primary IOOA,and a significant decrease in the torsional angle occurs after IO recession in both types of IOOA.
